Annals of Occupational and Environmental Medicine

Original Article

Factors affecting heat-related illness symptoms among school food service workers: a cross-sectional study in Korea: Nahyun Kim, Dongwhan Suh, Jia Ryu, Woo Chul Jeong, Yun-Keun Lee, Jinwoo Lee, Hyunjoo Kim; Ann Occup Environ Med 2025;37:e30. Published online September 2, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e30

Abstract PDF Supplementary Material: Background
School food service workers are highly likely to develop heat-related illnesses because of their work environment. However, studies that have examined the risk of heat-related illnesses among them are limited. The purpose of this study was to investigate the status of heat exposure, implementation of heat wave countermeasures, and prevalence of heat-related illness symptoms among school food service workers in Korea, and to explore the relationship between them.
Methods
A cross-sectional study was conducted through an online survey of school food service workers from May 25 to June 12, 2023, via three labor unions. We analyzed 6,244 valid responses. We assessed general characteristics, heat-related illness symptoms (heat rash, heat cramps, heat edema, heat exhaustion, heat syncope), duration of heat exposure during heat waves, and heat wave preventive measures. Multiple logistic regression analyses were performed, with adjustments for age, occupation, hypertension, diabetes, and school type.
Results
More than one-third of school food service workers reported heat exposure between May and September exceeding 4 hours daily, and 94.6% experienced at least one heat-related illness symptom during the last year. A dose-response relationship was observed between heat exposure duration and heat-related illness symptoms (p for trend < 0.001). School food service workers who did not have increased rest periods or did not reduce high-heat prepared foods showed significantly higher odds ratios for heat-related illness symptoms.
Conclusions
School food service workers experience substantial heat exposure and a high prevalence of heat-related illness symptoms. The risk of heat-related illness symptoms was associated with extended duration of heat exposure. Increasing rest periods and reducing high-heat food preparation were effective preventive measures. These findings underscore the need for improved heat exposure management and implementation of effective preventive measures to protect the health of school food service workers, with particular attention to appropriate rest periods.

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Research Article

Effects of high occupational physical activity, aging, and exercise on heart rate variability among male workers: Dongmug Kang, Youngki Kim, Jongeun Kim, Yongsik Hwang, Byungmann Cho, Taekjong Hong, Byungmok Sung, Yonghwan Lee; Ann Occup Environ Med 2015;27:22. Published online September 25, 2015; DOI: https://doi.org/10.1186/s40557-015-0073-0

Abstract PDF

Objectives

Effects of aging and leisure time physical activity (LPA) might influence the effect of occupational physical activity (OPA) on risk for cardiovascular disease (CVD). This study was conducted to determine whether OPA affects CVD after controlling the effects of LPA and other risk factors for CVD such as job stress.

Methods

Participants were 131 male Korean manual workers. Tests for heart rate variability (HRV) were conducted for five minutes in the morning at work. We defined OPA as the combined concept of relative heart rate ratio (RHR), evaluated using a heart rate monitor.

Results

Whereas high OPA was not related to any HRV items in the younger age group, high OPA was associated with an increased number of low-value cases among all HRV items in older workers. Exercise had beneficial effects only in the younger group. After controlling for exercise and other risk factors, the odds ratios of the root-mean square of the difference of successive normal R-R intervals (rMSSD) and high frequency band power (HF) among the older age and high OPA group compared with the younger age and low OPA group were 64.0 and 18.5, respectively. Social support and shift work were independent risk factors in HRV.

Conclusions

OPA in aging workers increases CVD risks. This study provides support for the need for protection of aging workers from physical work overload, and indicates the need for further study of optimal limits of OPA.

Citations

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